Predictive and clinical value of cerebral microemboli detection in cardnic patients

Cardioembolic strokes have a worse prognosis and produce larger and more disabling strokes than other ischemic stroke subtypes. We sought to evaluate the prevalence of High-intensity-transient-signals [HITS] in patients having different cardiac sources of emboli and the value of transcranial Doppler [TCD] in stroke prediction. consecutive cardiac patients were subjected to ECG, transthoracic echocardiography, and TCD examination. a total of 45 cardiac patients were investigated; twenty patients with rheumatic heart disease, 10 with prosthetic valves, and 15 with myocardial ischemia. In all patients, the presence of HITS was not affected by the patients' age, gender, the presence of risk factors, the platelet count or the INR level. Cerebral strokes were significantly higher in patients with HITS than those without. In patients with prosthetic heart valves, 60% was HITS-positive with a mean rate of 14.2 +/- 6.49/ 30 minutes, which was significantly higher than myocardial ischemia and rheumatic heart disease patients. In myocardial ischemia group, a higher prevalence of HITS was found with left ventricular ejection fraction [LVEF] < 55% and left ventricular thrombus.In rheumatic heart and ischemic heart disease groups > 80% of patients treated with antithrombotics and/or thrombolytics did not show any HITS, while in mechanical heart valves only 20% of patients received anticoagulants plus aspirin was HITS-negative. Cerebral strokes are significantly higher in cardiac patients with detected HITS than those without. In patients with prosthetic heart valves, anticoagulants didn 't significantly decrease or clear HITS

impact of dyslipidemia on left ventricular functions and ventricular thrombosis following acute myocardial infarction

Background: Dyslipidemia is a modifiable risk factor for development and progression of coronary atherosclerosis. The role of dyslipidemia on the evolution of left ventricular dysfunction [LVD], heart failure [HF] and left ventricular thrombosis [LVT] following acute myocardial infarction [AMI] has not been stressed upon

Objectives: The purpose of this comparative study was to evaluate the ventricular systolic, diastotic functions and LVT in the dyslipidemic versus the non-dyslipidemic groups

Subjects and Methods: One hundred patients with firs attack AMI. We evaluated: Clinical, biochemical, alectrocardiography and echocardiographic graphic studies were undertaken

Results: The ejection fraction [EF] and fractional shortening [FS] were significantly lower with higher scores of wall motion abnormalities and increased LVT among the dyslipidemic Group

Conclusion: In patients with first attack AMI, dyslipidemia has a significant detrimental effects on left ventricular [LV] systolic function with significant higher tendency for development of LVT. These deleterious effects are more evident in males, relatively young age groups [<60 ys] and those with anterior wall AMi

Assessment of some antioxidant vitamins in essential hypertension and renal-related hypertension

Background: hypertension [HTN] and chronic renal failure [CRF] are known risk factors for atherosclerosis. Oxidative stress has been implicated as an important etiologic factor in this complication. Antioxidants can alleviate the process of thermogenesis through multifactorial reactions that finally inhibit lipid peroxidation

Objectives: this work aimed to determine concentrations of the main antioxidant vitamins [serum alpha tocopherol, serum Beta-carotene and plasma ascorbic acid] in essential HTN and to assess the possible effect of hypertension due to end-stage renal disease [ESRD] on these antioxidant vitamins

Subjects and Methods: serum alpha-tocopherol, serum B-carotene and plasma ascorbic acid concentrations were determined by spectrophotometric methods in thoroughly diagnosed 20 patients with essential HTN and 20 patients with renal related hypertension [HTN+CRF]. Similar investigations were done for 15 clinically healthy control volunteers

Results: serum concentrations of alpha-tocopherol were subnormal in both essential HTN and renal related hypertension [HTN+CRF] but the decrease was only significant in the latter group. Subsequently, the difference between the essential HTN renal related hypertension groups was significant. With regard to Beta-carotene, its serum concentration was significantly lower than normal in both essential HTN and HTN CAF but the difference between both patient groups was insignificant. With regard to plasma ascorbic acid, its concentration was significantly lower in both essential HTN and HTN + CRF groups than normal mean value but the mean value of plasma ascorbic acid in HTN+ CRF was significantly lower than that in essential HTN alone

Conclusion: HTN is significantly related to the main antioxidant vitamins [a-tocopherol, Beta-carotene and ascorbic acid]. CRF has an additive effect to HTN on both water soluble antioxidant vitamin [ascorbic acid] and lipid soluble forms [alpha tocopherol and Beta-carotene]